【摘要】：目的全頜曲面斷層片能觀察全口牙列以及上下頜骨的發(fā)育情況,更適合觀察研究牙齒的生長(zhǎng)發(fā)育;臨床上常常利用全景片來研究磨牙的萌出情況,結(jié)合計(jì)算機(jī)技術(shù)形成的數(shù)字全景片,能將磨牙的真實(shí)情況更精確地顯示。通過分析11-14歲青少年恒磨牙(主要是第二磨牙M2和第三磨牙M3)的影像學(xué)表現(xiàn),研究恒磨牙的發(fā)育、萌出情況,以及M3、M2的發(fā)育關(guān)系。方法從常州市口腔醫(yī)院影像資料中抽取2013年1-10月期間拍攝的全頜曲面斷層片,樣本納入標(biāo)準(zhǔn)為:①年齡為11-14歲的青少年;②圖像清晰度好,下頜骨無明顯變形、扭曲;③無M3的拔除史;④X片顯示無先天缺牙以及牙本質(zhì)發(fā)育不全等;⑤未做過正畸治療;⑥單頜牙弓擁擠不超過2mm,無過大牙、過小牙、下沉牙、異位牙、多生牙等,男性150例,女性195例,共345張。研究分析第二、三磨牙的牙齒生長(zhǎng)狀況、牙根發(fā)育狀態(tài)、發(fā)育差異等并進(jìn)行發(fā)育分期;第三磨牙萌出位置、與第二磨牙的間距并分析兩者的相關(guān)性,初步預(yù)測(cè)分析第三磨牙阻生及拔除的可能和第一、二磨牙的齲患及阻生情況。結(jié)果在11-14歲青少年中,M2處于發(fā)育G期的比例為43.26%,下頜整體發(fā)育早于上頜(Z=-11.685,P值0.000,P0.05);女性明顯較男性發(fā)育早(Z=-3.058,P值0.002,P0.05);不同年齡的發(fā)育階段有顯著性差異(c2=425.427,P值0.001)。21顆阻生,均為下頜近中傾斜,占已萌出下頜M2總數(shù)的3.83%。M3處于發(fā)育C期的比例為33.26%,女性比男性發(fā)育早(Z=-2.056,P值0.040,P0.05);下頜M3發(fā)育早于上頜(Z=-3.419,P值0.001,P0.05);不同年齡的發(fā)育階段有顯著性差異(c2=501.301,P值0.001)。M3與M2計(jì)算Spearman相關(guān)系數(shù)是0.869,P0.001,差異有統(tǒng)計(jì)學(xué)意義,說明二者存在相關(guān)性。M1的齲壞率為0.72%。已萌出的下頜M2近中阻生組的下頜第二磨牙傾角(Am2-m1)大于萌出組,有顯著性差異(P0.05);萌出組的女性下頜第二磨牙傾角小于男性,有顯著差異(P0.05)。結(jié)論11-14歲的青少年M2的發(fā)育階段大部分位于G階段,是進(jìn)行牙齒矯治的最佳有利時(shí)期。該階段需要重視下頜M2牙傾角的變化,防止近中阻生;已有傾向者需要及時(shí)干預(yù)。女性的M2和M3發(fā)育均明顯較男性早。M2和M3的生長(zhǎng)趨勢(shì)具有一致性,經(jīng)Spearman相關(guān)分析,兩者發(fā)育存在相關(guān)性,可以為分析恒牙牙合早期后段牙弓狀況提供參考,對(duì)于錯(cuò)牙合畸形的預(yù)測(cè)和矯治計(jì)劃的制定具有重要的臨床意義。
[Abstract]:Objective to observe the development of total dentition and upper and mandible, and to study the growth and development of teeth, panoramic films are often used to study the eruption of molars in clinic. Combined with computer technology, the digital panorama can show the real situation of molars more accurately. By analyzing the imaging features of permanent molars (M2 and M3) of 11-14 years old, the development, eruption and developmental relationship of M3M 2 were studied. Methods Total maxillary surface tomograms were taken from the imaging data of Changzhou Stomatological Hospital from January to October 2013. The inclusion criteria of the images were: 1: 1 the young people aged 11 to 14 years old had good definition of images, the mandible had no obvious deformation and distortion. (3) the extraction history without M3 and 4X film showed that no congenital tooth defects and dentin dysplasia etc. 5. No orthodontic treatment, no more than 2mm crowding of single maxillary arch, no large teeth, small teeth, sinking teeth, ectopic teeth, supernumerary teeth, etc., male 150 cases, male 150 cases. There were 195 women (345). The second and third molars were analyzed for tooth growth, root development, developmental differences and developmental stages, and the location of the eruption of the third molar and the distance between the second molar and the second molar were analyzed and the correlation between the two was analyzed. The possibility of impaction and extraction of the third molar and the caries of the first and second molars were preliminarily predicted and analyzed. Results the proportion of M _ 2 in G stage was 43.26, the whole mandibular development was earlier than that of the upper jaw (P = 0.000P05), the development of female was earlier than that of male (P = 0.002P), there was significant difference between different ages (C _ 2o _ 425.427P = 0.001). All of them were proximal and middle mandibular oblique. The proportion of 3.83%.M3 in developing C stage was 33.26%, the development of M3 in female was earlier than that in male (P = 0.040 P), the development of M3 in mandible was earlier than that in maxilla (P 0.05), there was significant difference in developmental stage of different age (C2501.301 P value 0.001). M3 was associated with M 2 calculation of Spearman. The coefficient was 0.869m (P 0.001), the difference was statistically significant. The caries rate of M1 was 0.72%. The mandibular second molar obliquity (Am2-m1) of the newly erupted M2 group was higher than that of the eruption group (P0.05), and the female mandibular second molar obliquity angle of the eruption group was lower than that of the male (P0.05). Conclusion the developmental stage of M 2 in 11-14 years old adolescents is mostly in G stage, which is the best favorable period for dental correction. In this stage, attention should be paid to the change of mandibular M2 obliquity to prevent proximal and middle impaction, and those who have tendency need to intervene in time. The growth trend of M2 and M3 in females was significantly consistent with that in males. By Spearman correlation analysis, there was a correlation between the development of M2 and M3, which could be used as a reference for the analysis of posterior arch in early permanent teeth. It has important clinical significance for the prediction of malocclusion and the establishment of correction plan.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R783.5

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本文編號(hào)：2257812